肿瘤坏死因子α和高敏C反应蛋白在渗出性胸腔积液诊断中的应用

Tumor necrosis factor alpha and high sensitivity C-reactive protein in diagnosis of exudative pleural effusion.

作者信息

Rezaeetalab Fariba, Parizadeh Seyed Mohhamad Reza, Esmaeely Habibollah, Akbari Hadi, Akbari Farzaneh, Saberi Soheila

机构信息

Assistant Professor, Department of Pulmonary Diseases, Lung Diseases and Tuberculosis Research Center (LD/TRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Res Med Sci. 2011 Nov;16(11):1405-9.

PMID:22973340

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3430056/

Abstract

BACKGROUND

Differentiation between exudative and transudative pleural effusions is the initial step in assessment of pleural effusion. The aim of this study was to determine whether high sensitivity C-reactive protein (hsCRP) and tumor necrosis factor α (TNFα) are diagnostic utilities for exudative pleural effusion.

METHODS

This experimental study assessed 79 patients with pleural effusion who underwent diagnostic evaluations at Imam Reza hospital, Mashhad, Iran in 2009-2010. The complete biochemical analysis of pleural fluid, pleural fluid culture, and pathological examination of pleural fluid and tissue were performed. Moreover, hsCRP and TNFα concentrations were measured in pleural fluid samples. The data was analyzed by student's t-test and Mann-Whitney test.

RESULTS

According to Light's criteria, 50 patients (63.30%) had exudative effusions while 29 subjects (36.70%) had transudative effusion. The pleural fluid concentrations of hsCRP and TNFα were significantly higher in the exudative group than the transudative group (p < 0.05). At a cutoff value of 5 mg/L for hsCRP, the results showed 94% sensitivity and 96.6% specificity. Regarding TNFα, a cutoff value of 12.9 ng/dl represented 96% sensitivity and 93% specificity.

CONCLUSIONS

HsCRP and TNFα levels may be considered as beneficial diagnostic factors for detecting exudative effusion in patients with pleural effusion.

摘要

背景

区分渗出性胸腔积液和漏出性胸腔积液是评估胸腔积液的第一步。本研究的目的是确定高敏C反应蛋白（hsCRP）和肿瘤坏死因子α（TNFα）是否可用于诊断渗出性胸腔积液。

方法

本实验性研究评估了2009年至2010年在伊朗马什哈德伊玛目礼萨医院接受诊断评估的79例胸腔积液患者。对胸腔积液进行了全面的生化分析、胸腔积液培养以及胸腔积液和组织的病理检查。此外，还测量了胸腔积液样本中的hsCRP和TNFα浓度。数据采用学生t检验和曼-惠特尼检验进行分析。

结果

根据Light标准，50例患者（63.30%）为渗出性胸腔积液，29例患者（36.70%）为漏出性胸腔积液。渗出性胸腔积液组的胸腔积液hsCRP和TNFα浓度显著高于漏出性胸腔积液组（p < 0.05）。hsCRP的临界值为5 mg/L时，结果显示敏感性为94%，特异性为96.6%。对于TNFα，临界值为12.9 ng/dl时，敏感性为96%，特异性为93%。